Aching for Answers: Navigating Menopausal Joint Pain

By
Elizabeth Gordon
March 27, 2024
5 min read
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Aching for Answers: Navigating Menopausal Joint Pain

Menopause comes with a slew of symptoms you’re probably familiar with: hot flashes, mood swings, insomnia, and more. But there's another symptom that affects over half of women around menopause — and it’s rarely thought of as a symptom of this phase of life. That's joint pain, or as it's known in medical circles, “menopausal arthralgia.”

In this article, we’ll discuss menopause-related joint pain, discover why estrogen is so important for our joint health, learn how menopause impacts this common later-age challenge, and find out what treatments are available to help you get relief. Let’s dive in.

How menopause causes joint pain

When most people think of estrogen, they think of a sex hormone that’s related to our reproductive health. But estrogen affects many other areas of our bodies and plays a vital role in safeguarding our joint health. 


Estrogen protects cartilage and bone

Estrogen is crucial to joint and bone health in a number of ways. First, it protects our cartilage. It does this by controlling enzymes that cause damage and by boosting elasticity through supporting glycosaminoglycan production. 

Another way it benefits our joints is by helping to regulate fluid balance in our bodies. Having the right amount of fluid is important because cartilage is made of about 80% water. Water is also a significant component of synovial fluid. This gel-like substance greases the cartilage and enables joints to move freely.  

Estrogen also plays a key role in our bone health by preventing bone loss and promoting bone formation to keep our bones dense and strong. 

When our estrogen levels decrease, all of these amazing protections go away and damage to our cartilage and other tissues causes friction and pain in our joints. For women who experience early menopause, these adverse changes start sooner, leaving joints vulnerable for longer.  

Estrogen reduces inflammation

Pain and stiffness in your joints can also be caused by inflammation. When the tissues of your joints become inflamed, they release chemicals that irritate nerves and increase fluid in the joint. Chronic inflammation can damage cartilage, bones, tendons, or ligaments. 

Estrogen works to help manage inflammation all over the body by reducing the production of chemicals that promote swelling. It also controls the behavior of immune cells, preventing them from overreacting and causing excessive inflammation.  

Numerous studies have shown that the decline in estrogen during menopause drives body-wide inflammation and may contribute to the onset or worsening of inflammatory conditions.

Estrogen helps prevent pain

Beyond helping your bones and joints, studies show that estrogen helps reduce pain. You're likely to experience less intense pain when estrogen levels are normal. As you enter menopause and your estrogen levels decline, you might find an increase in joint issues and a heightened sensitivity to pain. 

Adding another layer to this, the fluctuation of hormones during menopause that causes vasomotor symptoms such as hot flashes and exhaustion can alter our tolerance and perception of pain. This means that having hot flashes and other vasomotor symptoms can heighten your awareness of other areas of pain in your body.

To sum it up, when estrogen levels fluctuate and decrease — as they do during menopause — we not only lose the protective effects of this powerful hormone but we also experience an increase in inflammation and damage. 

Much more research is needed to fully understand how the hormonal changes we undergo monthly— and throughout our lives — impact conditions that cause joint pain.

What does menopause-related joint pain feel like?

Menopause-related joint pain manifests differently for everyone. Commonly affected areas include the back, neck, jaw, shoulders, and elbows, but your wrists and fingers can also be impacted. You may wake up with stiffness and swelling that eases as you become more active throughout the day — or it might get worse. You might feel a deep and continuous ache in your joints, sharp twinges, or a burning sensation after physical activity.

What else causes joint pain in women?

The decline in estrogen women experience during menopause clearly causes many challenges for our joints. However, there are many causes of joint pain — including over 100 forms of arthritis and the normal wear and tear of aging— that could be the source of your pain. Many of these conditions affect more females than males and some increase in severity around the time of menopause. 

Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis, affecting one-third of people over the age of 65 — and 62% of those people are women. OA occurs when the protective cartilage that cushions the ends of the bone wears down. Worn down cartilage makes movement painful and finally leads to joint failure. Common areas that are affected are the knees, hips, hands, and spine. Several studies have found that menopause increases your risk of developing osteoarthritis.

Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is an autoimmune condition where the body's immune system, which usually protects against foreign invaders, goes awry and attacks its own joints. This internal battle results in inflammation and can severely damage the lining of the joints. RA affects three times as many women as men

We know that fluctuations in our hormones affect inflammatory arthritis, as many young women with Rheumatoid and Psoriatic Arthritis report flares in their symptoms when they have their period. But, many studies disagree on the impact menopause has inflammatory arthritis conditions and more research is needed. 

Fibromyalgia

Fibromyalgia is a chronic, long-lasting disorder that causes pain and tenderness throughout the body, fatigue, and trouble sleeping. While it doesn't cause joint damage, the constant pain and fatigue can significantly interfere with daily activities. The exact cause is unknown, but it's believed to involve various genetic, environmental, and psychological factors. Women are nine times more likely to have Fibromyalgia.

Joint pain and depression during menopause

Living with joint pain can take a toll not just on your body but also on your mental well-being. The daily stress of dealing with persistent pain can disrupt the balance of mood-related chemicals in your brain, like cortisol and serotonin, potentially leading to depression

But it's a two-way street: if you're already depressed, your ability to cope with pain weakens, making your condition seem worse. This creates a vicious cycle where pain fuels depression, and depression intensifies pain.

Given that women are already twice as likely to be diagnosed with depression as men, the drop in estrogen during menopause can further exacerbate this cycle. Taking care of your physical and emotional pain is crucial during menopause, so consider seeking professional help if you find yourself stuck in this challenging loop.

How can I relieve my menopausal joint pain?

If you want to relieve joint pain, medication, supplements, and lifestyle modifications can help.  Start by making an appointment with your primary care physician or menopause specialist to check your hormone levels. You can work together to develop a treatment plan that works for you if you’re entering menopause that will also benefit your joint health.

At your appointment, talk to your doctor about everything you’re experiencing so you can rule out any other serious medical issues that might be causing your joint pain. You’ll also want to make sure any methods you’re exploring to relieve joint pain are safe with your current medications and health needs.

Non-hormonal medications and supplements

Many over-the-counter medications can be used to treat menopause-related joint pain including Tylenol, Aspirin, or Ibuprofen. Additionally, adding certain supplements into your daily routine can also help prevent and alleviate joint pain. Some of our favorite supplements include:

  • Omegas: Fish oil, rich in omega-3 fatty acids, and primrose oil, high in omega-6, can help reduce inflammation, benefiting the joints and the heart. 

  • Curcurmin: Curcumin, found in turmeric, eases inflammation and sore muscles. 

  • Glucosamine and Chondritin Sulfate: Glucosamine and chondroitin sulfates, natural cartilage components, can relieve pain for many, though results vary. 

  • Hyaluronic acid: Taking a hyaluronic acid supplement can increase the density of the synovial fluid in your joints, delaying further cartilage damage.

Lastly, CBD, from the cannabis plant, shows potential in pain and inflammation relief. If you’re considering taking CBD, consult a physician and choose products from trusted sources.

Menopause hormone therapy

Since joint pain is caused or at least exacerbated by a drop in estrogen levels, replacing some of your lost estrogen can help relieve joint pain.

Bioidentical hormone replacement therapy is an FDA-approved treatment that replenishes your estrogen supply and helps you gradually wean your body off this vital hormone. It’s currently the most powerful and effective method for addressing menopausal symptoms.

A recent study involving over 10,000 postmenopausal women revealed that women who took daily oral estrogen supplementation experienced a marked reduction in joint pain and swelling.

While menopause hormone therapy has numerous benefits, it's essential to approach this treatment with a well-informed perspective. So talk to your doctor or menopause specialist if you’d like to explore using this method to treat your joint pain.

What can I do to prevent joint pain?

Unlike other menopause symptoms that may ease with time, joint pain can persist even after our hormones stabilize. Making some lifestyle changes can help reduce discomfort and prevent future damage.

Lifestyle modifications to prevent joint pain

  • Exercise regularly
  • Get enough sleep
  • Eat more anti-inflammatory foods
  • Be mindful of your stress levels
  • Stay hydrated

Alternative therapies for menopause-related joint pain

In addition to lifestyle changes, consider some alternative therapies to help relieve pain and prevent further damage to your joints.

  • Try acupuncture: This ancient Chinese practice involves inserting thin needles into specific points on the body, and it's been shown to relieve various types of pain, including joint discomfort.

  • Find an aqua therapy class: Working out in a pool provides resistance for muscle strengthening while being gentle on the joints, making it a double win for those suffering from menopausal joint pain.

  • Sign up for physical therapy: A physical therapist can provide you with a customized exercise regimen that strengthens your joints and muscles, which can help in reducing pain.

Remember, treating menopausal joint pain often takes a multi-pronged approach that can include medication, lifestyle changes, and alternative therapies. Always consult a healthcare professional for a diagnosis and treatment plan that's appropriate for you.

Living life with less joint pain 

While many of us have heard of — and are somewhat prepared for hot flashes and mood shifts of menopause — the unexpected intrusion of pain in daily life can catch us off guard and weigh us down over time. 

Be it hormone therapy, natural supplements, or holistic treatments, the compassionate menopause experts at FemGevity are here to help you understand what’s causing your joint discomfort and help you get the care you need.

Resources

Journal of Neuroinflammation. (2020). The peri-menopause in a woman’s life: a systemic inflammatory phase that enables later neurodegenerative disease. Retrieved from: https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-020-01998-9

National Library of Medicine. (2012). Predictors of Change in Pain and Physical Functioning among Post-Menopausal Women with Recurrent Pain Conditions in the Women’s Health Initiative Observational Cohort. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249604/

National Library of Medicine. (2004). S-Adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: A double-blind cross-over trial. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC387830/

National Library of Medicine (2013). Estrogen alone and joint symptoms in the Women's Health Initiative randomized trial. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/23511705/

National Library of Medicine. (2020). Musculoskeletal Pain during the Menopausal Transition: A Systematic Review and Meta-Analysis. Retrieved from: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7710408/

National Library of Medicine. (2012). Early menopause and severity of rheumatoid arthritis in women older than 45 years. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580586/

National Library of Medicine. (2010). Oestrogen is important for maintenance of cartilage and subchondral bone in a murine model of knee osteoarthritis. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991014/

National Library of Medicine. (2017). Menopause and rheumatic disease. Retreived from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385852/

Nature Scientific Reports. (2017). Estrogen deficiency accelerates lumbar facet joints arthritis. Retrieved from: https://doi.org/10.1038/s41598-017-01427-7

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